Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a non-healing, foul-smelling wound characterized by progressive tissue destruction and visible larval activity. Reports sensation of movement within the wound bed, localized pruritus, and increasing pain. Recent history of travel to endemic regions or exposure to livestock/open wounds in unsanitary conditions. No systemic symptoms of sepsis noted.
Clinical Examination Findings
Physical examination reveals a necrotic, malodorous wound bed with multiple deep, burrowing sinus tracts. Larvae of Cochliomyia hominivorax identified within the wound cavity; surrounding tissue exhibits significant inflammation, erythema, and serosanguinous discharge. Wound edges are irregular with evidence of undermining. No regional lymphadenopathy or systemic febrile response detected.
Treatment Protocol
Immediate mechanical debridement performed to remove visible larvae and necrotic tissue. Wound irrigated with sterile saline. Topical application of ivermectin or appropriate larvicidal agent as indicated. Wound dressed with non-adherent, breathable material. Prescribed prophylactic systemic antibiotics to cover secondary bacterial infection. Scheduled follow-up for wound re-assessment and secondary debridement if necessary.